MRCP helps establish surgical modality for type Ⅰ Mirizzi syndrome / 中华普通外科杂志

ABSTRACT

Objective To evaluate magnetic resonance cholangiopancreatography (MRCP) in identifying Mirizzi syndrome and surgical modality Methods According to MRCP identification open laparotomy was adopted for those 7 case with gallbladder enlargemeng incarcerated stones close to the hilum and long segment obstruction of the common bile duct.Other 16 type Ⅰ Mirizzi syndrome cases without these characteristics underwent LC.Results Among 23 patients in MRCP group 22 cases were successfully operated on based on preoperatively planned surgical procedures.Only one was converted to open surgery because of the variation of gallbladder artery.While in 23 cases without undergoing preoperative MRCP examination,7 out of 12 cases assigned to LC were converted to open cholecystectomy (OC),11cases were done by OC.The Preoperative accurate diagnosis rate was 82.6％ (19/23) in MRCP patients with type Mirizzi Ⅰ syndrome.The success rate of preassigned surgical approach was 95.7％ (22 / 23).While in non-MRCP group,the conversion rate was 58.3％ (7/12),the average length of stay were significantly prolonged.Conclusions Preoperative MRCP examination helps accurately establish the diagrosis of type Ⅰ Mirizzi syndrome,precisely plan appropriate surgical approaches.